Shoskes Daniel A, Thomas Kim D, Gomez Eyda
Department of Kidney Transplantation, Cleveland Clinic Florida, Weston, Florida 33331, USA.
J Urol. 2005 Feb;173(2):474-7. doi: 10.1097/01.ju.0000150062.60633.b2.
Category III chronic prostatitis/chronic pelvic pain syndrome (CPPS) is a common debilitating condition of unclear etiology. Patients often have prostatic calcifications but a link to symptoms is controversial. Nanobacteria are implicated in stone formation in the urinary tract and, therefore, therapy to eliminate nanobacteria and the stones that they produce might have an impact on CPPS symptoms.
A total of 16 men with recalcitrant CPPS refractory to multiple prior therapies were treated with comET (Nanobac Life Sciences, Tampa, Florida), which consists of 500 mg tetracycline, a proprietary nutraceutical and an ethylenediaminetetraacetic acid suppository daily. The National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI), transrectal ultrasound, and blood and urine tests for nanobacterial antigen were performed at the start and conclusion of 3 months of therapy. One patient was lost to followup.
Mean NIH-CPSI total score +/- SD decreased from 25.7 +/- 1.6 to 13.7 +/- 2.0 (p <0.0001). Significant improvement was seen in each subscore domain. A total of 12 patients (80%) had at least 25% improvement on NIH-CPSI and 8 (53%) had at least 50% improvement. Nanobacterial antigen or antibody was found in 60% of serum and 40% of urine samples. In 10 patients who underwent transrectal ultrasound after therapy prostatic stones were decreased in size or resolved in 50%.
Therapy designed to eliminate nanobacteria resulted in significant improvement in the symptoms of recalcitrant CPPS in the majority of men, whether due to the treatment of stone producing nanobacteria or through some other mechanism. Prospective placebo controlled trials are warranted.
III类慢性前列腺炎/慢性盆腔疼痛综合征(CPPS)是一种常见的使人衰弱的疾病,病因不明。患者常伴有前列腺钙化,但钙化与症状之间的联系存在争议。纳米细菌与尿路结石形成有关,因此,消除纳米细菌及其产生的结石的治疗可能会对CPPS症状产生影响。
共有16名对多种先前治疗均难治的顽固性CPPS男性患者接受了comET(佛罗里达州坦帕市的Nanobac生命科学公司生产)治疗,comET由500毫克四环素、一种专利营养保健品和一枚乙二胺四乙酸栓剂组成,每日使用。在治疗3个月开始和结束时,进行了美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)、经直肠超声检查以及纳米细菌抗原的血液和尿液检测。有1名患者失访。
NIH-CPSI总分的平均值±标准差从25.7±1.6降至13.7±2.0(p<0.0001)。各子评分领域均有显著改善。共有12名患者(80%)的NIH-CPSI至少改善了25%,8名患者(53%)至少改善了50%。60%的血清样本和40%的尿液样本中发现了纳米细菌抗原或抗体。10名在治疗后接受经直肠超声检查的患者中,50%的患者前列腺结石尺寸减小或消失。
旨在消除纳米细菌的治疗使大多数顽固性CPPS男性患者的症状得到显著改善,无论是由于治疗产生结石的纳米细菌还是通过其他某种机制。有必要进行前瞻性安慰剂对照试验。